Individual
MS. LISA GAY SHOCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N., MSN
Contact information
Practice address
5201 RAYMOND ST, ORLANDO, FL 32803-8208
(407) 646-5500
Mailing address
2915 LICHEN LN, UNIT C, CLEARWATER, FL 33760-4522
(727) 531-7170
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN 2525912
FL
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
03/31/2008
Last updated
11/13/2016
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